Provider Demographics
NPI:1588460422
Name:DEEN, MARIAMA K
Entity type:Individual
Prefix:
First Name:MARIAMA
Middle Name:K
Last Name:DEEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12419 DORSEY LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-5318
Mailing Address - Country:US
Mailing Address - Phone:240-596-9737
Mailing Address - Fax:
Practice Address - Street 1:12419 DORSEY LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-5318
Practice Address - Country:US
Practice Address - Phone:240-596-9737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician